Following our February 2025 Member forum on NDIS Reforms, OTA has been busy advocating for our members working in the NDIS. This has included a meeting with the office of Amanda Rishworth MP, the new NDIS Minister, where we discussed the OTA Election playbook and our key disability and NDIS issues and continued to emphasise our concerns about the speed of NDIS reforms, and the need for clinical input on NDIS representative committees.

OTA Members can access the recording of the February 2025 Member Forum on NDIS Reforms And read OTA’s 2025 Federal Election Statement

NDIA Support Needs Assessments

In response to the NDIA’s February call out to market for tender applications and information on support needs assessment tools, OTA compiled and submitted two briefings to NDIA on assessment tools for children, and specialised assessments for adults (which included home medicalisations, assistive technology and vehicle modifications). We used feedback from members and participants at the February NDIS forum, and input from our specialist OTs in our practice team to develop a list of suitable tools that are used in isolation or combination by OTs as part of their holistic assessment of a client.

For children’s assessment tools, OTA strongly emphasised that NDIA take a comprehensive, evidence-based approach to assessing children’s needs, that allows for the use of a combination of standardised and non-standardised tools, and considers the child's environment, strengths, and functional abilities, and be carried out by a suitably qualified assessor workforce.

Similarly for specific adult assessment tools, OTA emphasised that it is essential that such assessments are conducted by qualified professionals with appropriate expertise, and in the case of home modifications and vehicle modifications, should only be conducted by occupational therapists. Our advice also noted that there is no single assessment tool that can fully identify a participant’s needs across multiple domains and under current best practice conventions, clinicians rely on evidence-based frameworks and models of practice to tailor the needs assessment process to the client. These frameworks typically emphasise a holistic, person-centred approach that integrates multiple tools and assessment methods, clinical observations, and professional reasoning.

In addition to this specific clinical feedback, OTA is also preparing advice for government on a quality and safe disability needs assessment that will be outlining the key role of OTs in functional and disability needs assessment and emphasising the need for a high quality, person centred, and trauma informed support needs assessment approach at the heart of the NDIS.

Clarifications on NDIS Supports List

Last year NDIA introduced guidelines on what NDIA funds can and cannot be spent on, called ‘NDIS Supports”.  OTA was concerned that the wording in the NDIS Supports list did not specifically refer to the full scope of OT services that OTs may provide, and may lead to exclusion of certain services. We immediately wrote to the NDIA to seek clarification on the list, including on specific terminology and exclusions, to ensure we can support members to provide OT services under the NDIS. 

The NDIA’s response contained some specific clarifications that are summarised below. We encourage members to read this summary in conjunction with relevant Operational Guidelines published by the NDIA which are designed to sit alongside the list of NDIS Supports. As always we want to hear form you if you experience issues with navigating the NDIS Supports List. Please email policy@otaus.com.au.

• Home modifications – OTA was concerned that the Support list did not include specific reference to OT. NDIA has confirmed that OT assessments and services are included in both category A and B (minor) home modifications as well as complex home modifications.

• Personal mobility equipment - NDIS has clarified that while not specifically mentioned, services to assess, prescribe, deliver, adjust and train a participant in successful use of an assistive product are included in this category.

• Activity based therapy – NDIA has clarified that for practitioners using a specific activity or intervention like games, or nature exposure, as part on a therapeutic intervention, this CAN still be funded as a therapy support. We were concerned that the list of non-NDIS Supports (the ‘out list’) excludes certain therapies like nature therapy and yoga therapy which may specifically exclude some OT interventions which utilise these activities as part of therapeutic interventions. NDIA has confirmed that they recognise that “most therapists utilise different activities or games in therapy sessions as standard practice, as part of building various skills. This may include board games, online games, Lego or an animal”. Our interpretation of their advice is that therapy supports, delivered by an allied health professional, that provide evidence-based therapy to help participants improve or maintain their functional capacity, and utilise certain activities, are permitted as NDIS Supports.

• Driving supports – NDIA clarified that driving supports do include assessment by a driver trained occupational therapist. OTA also sought clarification whether vehicle modifications include modified restraints and modified car seats. NDIA clarified that these would fit in the category of assistive products, which may also fall under the low-cost AT pathway valued at less than $1,500.

NDIS Evidence Advisory Committee

Government is moving to establish a new NDIS Evidence Advisory Committee, which will be operating from around mid-2025. The Committee will provide independent advice to government on the evidence for current and emerging therapeutic supports. OTA has nominated a representative on this committee and we are waiting to hear back on final membership. OTA is also meeting with DSS (the department convening the committee) in coming weeks to ensure that we are well placed to supply advice and information if required.

We are aware that other allied health professional bodies are developing evidence bases to submit to the committee. OTA’s recent communications with NDIA has reaffirmed that a significant range of OT services are considered therapy supports under current NDIS policy (noting that sensory modulations continue to be a challenge). Nevertheless, OTA will be seeking clarity from DSS on the agenda and remit of the committee to determine if there is a need to provide input on specific areas of OT practice to ensure their continued access under the NDIS, particularly sensory modulation. We also welcome feedback from members to policy@otaus.com.au if members have had a recommended intervention rejected by the NDIA on the grounds that it lacks an established evidence base, to enable us to identify systemic issues.

NDIS Commission

OTA recently attended the NDIS Quality and Safeguarding Commission’s quarterly Provider Advisory Group, and heard about their consultation on mandatory registration of support coordination and SIL. OTA expects more announcements on NDIS Registration, which may affect OTs, in the second half of the year, following the election. OTA’s representation on this committee has been beneficial in allowing us to provide early and robust feedback to the Commission on a range of regulatory matters. Earlier this year the Commission consulted with members on plans for guidance for participants and providers, and OTA provided feedback on guidance that was either incorrect or incorrectly represented the scope of occupational therapy under the NDIS, which was well received.

The Commission has published a Checklist for NDIS providers who, in the course of delivering NDIS supports, implement behaviour support plans and/or use regulated restrictive practices. This document promotes best practice around the implementation of behaviour support plans. [Access the Implementing Provider Checklist on the NDIS Commission website. ](Rules for behaviour support and restrictive practices | NDIS Quality and Safeguards Commission)

Foundational Supports

OTA continues to meet regularly with its Expert Advisory Groups on Early Childhood Foundational supports and Psychosocial Disability support, and associated working groups that have been established to progress work on OT roles and key elements of services for both cohorts.

The Early Childhood Foundational Supports Working Group is supporting development of an Early Childhood Foundational Supports Advice to Government Paper, which is intended to build on and complement current government policy to provide the concrete guidance needed to support the development of new and updated policies and programs for early childhood services.

The Children and Young people’s Psychosocial Disability Working Group is focussing on identifying opportunities to advance what occupational therapy practice should look like under foundational supports with a specific focus on key areas and intervention types, what other programs and supports might be needed (e.g. group programs, housing, employment and AOD supports), and what roles and professions might be needed across multidisciplinary teams.
The NSW Government is conducting an Inquiry into foundational and disability supports available for children and young people in New South Wales. The Select Committee is seeking submissions by 27 April. OTA is reviewing the terms of reference and will be preparing a submission.

Read more about the Select Committee on Foundational and Disability Supports Available for Children and Young People in New South Wales.